OLEG ANTONOV

Dr OLEG ANTONOV is a male medical professional, specializing in Family Medicine. He graduated in 1986.

Contact

11400 BUSTLETON AVE
PHILADELPHIA
PA
191162815

Tel:

OLEG ANTONOV Information

Npi 1841481561
Pac Id 4385715713
Professional Enrollment Id I20080612000462
Last Name ANTONOV
First Name OLEG
Middle Name
Suffix
Gender M
Credential
Medical School Name OTHER
Graduation Year 1986
Primary Specialty FAMILY MEDICINE
Secondary Specialty 1 DERMATOLOGY
Secondary Specialty 2
Secondary Specialty 3
Secondary Specialty 4
All Secondary Specialties DERMATOLOGY
Organization Legal Name
Group Practice Pac Id
Number Of Group Practice Members
Line 1 Street Address 11400 BUSTLETON AVE
Line 2 Street Address
Marker Of Address Line 2 Suppression
City PHILADELPHIA
State PA
Zip Code 191162815
Phone Number
Hospital Affiliation Ccn 1 390044
Hospital Affiliation Lbn 1 READING HOSPITAL
Hospital Affiliation Ccn 2
Hospital Affiliation Lbn 2
Hospital Affiliation Ccn 3
Hospital Affiliation Lbn 3
Hospital Affiliation Ccn 4
Hospital Affiliation Lbn 4
Hospital Affiliation Ccn 5
Hospital Affiliation Lbn 5
Professional Accepts Medicare Assignment Y

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